Basic Information
Provider Information
NPI: 1265831937
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HICKS
FirstName: NATALIE
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: MS, OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SENGER
OtherFirstName: NATALIE
OtherMiddleName:  
OtherNamePrefix: MISS
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 12411 SLAUSON AVE
Address2:  
City: WHITTIER
State: CA
PostalCode: 906062835
CountryCode: US
TelephoneNumber: 5626935449
FaxNumber:  
Practice Location
Address1: 12411 SLAUSON AVE
Address2:  
City: WHITTIER
State: CA
PostalCode: 906062835
CountryCode: US
TelephoneNumber: 5626935449
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/19/2014
LastUpdateDate: 08/19/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X14600CAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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